The must-read stories and debate in health policy and leadership.

This year’s Budget is very much spend then tax rather than tax and spend. There was much about support during the vestiges of covid. And there was plenty too on the hard times to come with cuts and taxes; the most pertinent to the NHS of which was the anticipated freeze to the pensions lifetime allowance.

Rishi No Dishy The Dosh

It looks like Skipton House will have to survive the coming year on the most meagre of rations, with a £9bn cut from this year into next.

In 2020-21, it got an £18bn uplift on its planned budget of £130bn to pay for the response to covid. This year, it has got just £3bn covid funding in pre-announced spending to support work addressing the elective backlog and rise in mental health issues, among other things. That brings the NHSE budget up to £139bn from the five-year funding settlement agreed with the long-term plan.

Don’t call me Shirley

Clearly efforts to tackle covid in 2021-22 will not cost a sixth of the activity in 2020-21, given that test and trace, PPE and other big spends are outside NHSE’ budget. And that’s before we consider the scale of the elective backlog and increases in other activity put off during covid.

Surely therefore the Treasury will open its purse in the months to come to meet additional needs in the health service.

This is the considered opinion of thinktank analysts and there are certainly funding asks from NHSE that have yet to be agreed. But without any guarantees of cash in black and white in the Treasury Red Book, it adds a large air of uncertainty at a time when the NHS and its staff are in desperate need of the reassurance of government’s full-throated support.